Measuring Child Disability in Low- and Middle-Income Countries: Challenges and Findings

Despite the large impact on child development, family life, and socio-economic environment of communities, data collection and research on child disability in low- and middle-income countries has been woefully inadequate. To address the need for data, UNICEF implemented, through the Multiple Indicator Cluster Survey programme, the Ten Questions Screen (TQ) for childhood disability. This screening tool has been developed with the objective of creating a low-cost and rapid method for identifying children in populations where professional resources are extremely scarce. By including the TQ, MICS has become the largest source of internationally comparable data on children with disabilities for developing countries.

The MICS disability module provides data on the type of impairments children have (seeing, hearing, language production and reception) or about actual health conditions, like epilepsy. Few questions are related to activity limitations (such as walking or learning). Questions are addressed to the mother (or primary caregiver) of each child in the household between 2 and 9 years of age.

Despite recommendations that the TQ be followed by a second-stage of clinical assessment to more accurately estimate prevalence of child disability, few countries have had sufficient financial or infrastructure resources to conduct diagnostic evaluations. The clinical evaluation proved to be expensive, time-consuming and challenging due, among other factors, to the lack of specialized medical personnel.

The objective of this presentation is to discuss the main challenges associated with the collection of data on child disability, and to provide an assessment of the MICS experience.